surprise medical billing

Federal Health Policy Update for February 22

The following is the latest health policy news from the federal government for February 16-22. Some of the language used below is taken directly from government documents. CMS and Medicaid DSH Payments CMS has published a final rule governing how third-party payers are factored into the calculation of hospitals’ Medicaid disproportionate share hospital-specific payment limit. This change requires that the calculation be based solely on Medicaid costs and payments and that costs and payments associated with dually eligible (Medicare and Medicaid) patients be excluded from the calculation of that limit. The effect of this change is that hospitals that are [...]

joe2024-02-22T22:00:03-05:00February 22, 2024|Alternative payment models, Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations, Medicaid upper-payment limit, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Providers Faring Well in Surprisingly Busy Dispute Resolution Process

Health care providers are winning more than three-quarters of all payment disputes being brought through an unexpectedly active federal Independent Dispute Resolution process. The process, created under the 2020 No Surprises Act to settle payment disagreements between providers and payers and to spare consumers surprise medical bills – especially for receiving emergency care from providers outside of their insurer’s network. 2023 saw 13 times more disputes during the first half of 2023 – nearly 300,000 cases in all – than federal officials anticipated. With more than 20 percent of the disputes submitted for resolution rejected as ineligible for the process, [...]

joe2024-02-20T21:23:48-05:00February 21, 2024|Uncategorized|

FEDERAL HEALTH POLICY UPDATE FOR THE WEEK OF SEPTEMBER 12-16

The following is the latest health policy news from the federal government for the week of September 12-16. Some of the language used below is taken directly from government documents. No Surprises Act The Department of Health and Human Services, the federal Office of Personnel Management, the Internal Revenue Service, the Department of the Treasury, the Department of Labor, and the Employee Benefits Security Administration have issued a request for information (RFI) seeking stakeholder comment on how to implement the No Surprises Act’s requirement that health care providers and payers give explanations of benefits and good-faith estimates of costs for [...]

iqtsupport2022-09-19T16:10:33-04:00September 19, 2022|340b, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for Friday, July 30

The following is the latest health policy news from the federal government as of 2:45 p.m. on Friday, July 30. Some of the language used below is taken directly from government documents. Final Medicare Payment Regulations for FY 2022 CMS has published four final rules for Medicare payments in FY 2022: FY 2022 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, Hospice and Home Health Quality Reporting Program Requirements. (See also CMS’s fact sheet) FY 2022 Inpatient Psychiatric Facilities Prospective Payment System and Quality Reporting Updates for Fiscal Year Beginning October 1, 2021 (FY 2022) (See [...]

iqtsupport2021-07-30T16:33:45-04:00July 30, 2021|Centers for Medicare & Medicaid Services, Coronavirus, COVID-19, hospitals, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, post-acute care|

Federal Health Policy Update for Friday, July 2

The following is the latest health policy news from the federal government as of 2:45 p.m. on Friday, July 2. Some of the language used below is taken directly from government documents. Supreme Court The Supreme Court has announced that it will hear a case in its next term challenging cuts in 340B payments and another involving Medicare disproportionate share. White House The White House has posted a transcript of the July 1 press briefing given by its COVID-19 response team and public health officials. The transcript includes the announcement that the federal government will be launching surge response teams [...]

iqtsupport2021-07-05T22:53:55-04:00July 5, 2021|340b, Coronavirus, COVID-19, Medicare disproportionate share, Medicare DSH|